Efficacy of Two Hand-Hygiene Methods to Reduce Organic Matter and Fecal Contamination on Farmworker Hands During Harvest Open Access

Abstract

Harvesters' hands have been repeatedly implicated in the contamination of produce and are thus a serious risk factor for foodborne illness. Improvements in the hygiene of harvesters are needed to reduce the risk associated with produce handling. This study evaluated two hand-hygiene methods in their ability to reduce both fecal indicator and dirt levels on farm workers' hands during harvest. Hand rinse samples were collected from 159 individuals performing various hygiene techniques: SaniTwice, hand washing, SaniTwice + harvest, hand washing + harvest, or no hygiene (control). Individuals in the SaniTwice group used an ethanol-based hand sanitizer and the hand washing group used water and a foam cleanser. Intervention groups submitted their hands for rinses immediately after performing the intervention. Intervention + harvest groups performed the intervention and then continued harvesting three five-gallon buckets of produce (for approximately 30 minutes) before submitting their hands for samples. Effects were measured using absorbance of hand rinses at 600nm (related to organic matter), and concentration and prevalence of fecal indicators (log10 CFU fecal coliforms, Enterococcus, and E. coli). Both intervention groups had a significantly lower mean absorbance than the control group (hand washing 0.01, SaniTwice 0.10, control 0.24) (p<0.01). The hand washing group had a significantly lower absorbance, than the SaniTwice group (p<0.01). The SaniTwice group had significantly lower concentrations of fecal coliforms and Enterococcus compared to the control group (SaniTwice 1.47 fecal coliforms, 3.11 Enterococcus, control 3.28 fecal coliforms, 4.09 Enterococcus) (p<0.01). There was no significant difference between concentrations of fecal coliforms, and Enterococcus, in the control and hand washing groups (hand washing 2.77 fecal coliforms, p=0.05, 3.99 Enterococcus, p=0.99). E. coli prevalence were very low for all groups (12.5-20% samples positive). The SaniTwice method was superior to hand washing in reducing fecal indicators and significantly reduced particulate matter compared to the control group on hands of harvesters, therefore this method might be a viable alternative to hand washing when soap and water are not available.

Table of Contents

LITERATURE REVIEW...1

INTRODUCTION...15

METHODS...21

RESULTS...28

DISCUSSION...34

CONCLUSION...37

REFERENCES...42

TABLE 1...47

TABLE 2...47

TABLE 3...48

TABLE 4...48

TABLE 5...49

TABLE 6...49

TABLE 7...50

TABLE 8...50

FIGURE 1...52

FIGURE 2...53

About this Master's Thesis

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School	Rollins School of Public Health
Department	Environmental Health
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Agriculture, General Health Sciences, Hygiene
Keyword	hand agriculture hygiene
Committee Chair / Thesis Advisor	Leon, Juan, Emory University
Committee Members	Tolbert, Paige, Emory University Bartz, Faith, Emory University
Partnering Agencies	Emory University schools, faculty or affiliated programs US (Federal) agency other than CDC University, college or educational institution (other than Emory)

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